Intended for healthcare professionals


School shootings are preventable, not inevitable

BMJ 2022; 377 doi: (Published 01 June 2022) Cite this as: BMJ 2022;377:o1378
  1. Paul Reeping,
  2. graduate research assistant
  1. Columbia University Mailman School of Public Health

We know how to prevent school shootings, all that’s left is for the US to do it, writes Paul Reeping

One of the fundamental roles of government is to protect its citizens from undue injury or death; this protection should be even further amplified for those citizens who are most vulnerable, including children and adolescents. The United States government budgets approximately one trillion dollars a year for military and police spending12 in order to protect the country and its citizens from undue harm. Yet despite this colossal investment in “defence,” we live in a country where the number one cause of death for children and adolescents is a gunshot wound.3 And tragedies, like the one that occurred on 24 May 2022, where 19 children and two teachers were murdered by an active shooter at Robb Elementary School in Uvalde, Texas, are far too common.

Worryingly, Uvalde was not an exception to the rule in terms of security spending; in fact, Uvalde could have been seen as an exemplar for many of the policies pushed by some politicians and gun rights activists to prevent school shootings. The school district had doubled its security budget since the Santa Fe school shooting where 10 people were killed just four years earlier.4 And the Uvalde district reportedly had its own police force, threat assessment teams, social media monitoring software, and security measures including fencing and a locked doors policy.4 Around 40% of Uvalde’s budget was spent on a police force,5 and the officers even held an active shooter training course just weeks before the school shooting occurred.6

And yet, these security measures did nothing to prevent the shooting, because most of these efforts—active shooter drills, police response, armed security officers, etc—are inherently reactionary. In other words, they were never meant to prevent a shooting, but rather were developed under the presumption that school shootings will occur and therefore must be slowed or stopped only after they’ve begun. Unfortunately, however, there is little or no evidence indicating that these reactionary policies have any effect on reducing mass or school shootings.7

America needs to re-evaluate how we view, discuss, and confront school shootings. As long as we live in a country where we assume and accept that school shootings are an inevitability, instead of the result of a unique failure of American society, we are setting ourselves up for a self-fulfilling prophecy of tragedy. School shootings are preventable. We know that permissive state gun laws are associated with more mass shootings8 and school shootings,9 and that licensing laws for firearms and bans of large capacity magazines are associated with fewer mass shootings.10 We know that Extreme Risk Protection Orders (ERPOs) work to prevent gun violence when properly implemented.11 We know that the average age of a school shooter is only 16,9 and that the youngest active school shooter was only 12.9 We therefore know that the implementation of laws for strict safe storage and child access prevention (CAP) would keep firearms out of the hands of the majority of school shooters. And we know that the Uvalde shooter—who was only 185—would not have been able to obtain an AR-15 if the minimum age of purchase was raised to 21.

Beyond laws, we also know that in order to actually protect children in our society, we must invest in the upstream factors that prevent school shootings and other types of gun violence. We know that investing in neighbourhoods and the built environment through the creation of libraries, parks, community centres, and green spaces reduces gun violence and also has other positive impacts on children and the community.12 We know that non-profit, community led programmes, such as career development initiatives and art programmes, are associated with lower rates of gun violence.13 We know that investing in the educational and social-emotional development of children, as well as restorative justice programmes, can help prevent violence.7 We also know that there are not enough mental health counsellors and social workers in schools to help treat students experiencing trauma and mental health disorders.14

Now imagine that a fraction of the one trillion dollars per year earmarked for “security and defence” that are mostly used on military spending and on the elimination of abstract, existential threats on American freedom, were instead used on the investments that we know reduce gun violence, protect our children, and overall improve the lives of the citizens of this country. Imagine that we implemented common sense gun safety laws that would keep guns out of the hands of those who want to hurt children and that would, in turn, lower the number of mass and school shootings. Imagine if we stopped thinking of school shootings as inevitable tragedies that need to be stopped by the police or prison-like security measures in schools, and instead as crises that should not and do not happen in this country.

We could prevent school shootings and actually protect the citizens—and children—of America from undue injury or death. School shootings are preventable, and we know exactly how to prevent them. We just actually have to do it.


  • Competing interests: None declared.

  • Provenance and peer review: Commissioned; not peer reviewed.